228 SW EVERETT MALL WAY GOODWILL 2023-07-28

F-42Zo14-603 Intake & Approval Sheet A (FOR PERMIT STAFF ONLY) S PERMIT # Ez7A,4 --b3r, BUILDING Intake OK by: Date: Intake Comments: e ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Garage/Accessory Struct. Size Number of Stories Basement ❑No ❑Yes , Fin / Unfin Type of Construction Occupancy Group Occupancy Load Fire Sprinklers: ❑Update Existing ❑New System [I Not Req'd Reason Sprinklers Required: Fire Alarm: ❑Update Existing ❑New System El Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No Add'] RCW 64.55 does required prior to final? ❑Yes ❑ No VALUATION CALCULATION: Total $ Additional Notes: Approved By: Date: FIRE DEPARTMENT Separate I Deferred Submittals Required: ❑Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE Review / Inspection Scope - ADD FIRE FEE Approved By: ,(, (Z Date: 2 2 Z ELECTRICAL Additional Notes: Approved By: Date: PLANNING - Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use . Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes []No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ Calculated: Credit: ❑Everett School Dist ❑Mukiiteo School Dist Additional Notes: Approved By: Date: PUBLIC W61RK8- Intake OK by: Date: Intake Comments: I PW Worksheet Needed if. =E]Sys Dev Eval ❑Traffic'Mit Eval (]Site Work or Drainage Proposed . ❑Backflow Prevention for high hazard: :(dental, medical, animals, mortuary, hospital, ;supportive housing) ....•.....••.................-....._•••._.....•......,....._......•,_.•........... ......... ....,•.•...,,•,•...............• ❑Route this folderfor PW Review at end --- PW Review Worksheet ❑This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder ❑Submitted Previously ❑Deferred El This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items ❑ A Separate PW Permit is Required (Permit #: PW ) AND ❑ Is located in this folder ❑ Is in a Separate Green Folderaoln with this folderfor permit issuance) ❑ WIII be issued separately (Separate Green Folder, PW Issued ahead of Bldg) ❑ Public Works has no scope--- PW Not Required Additional Notes: Approved By: Date: 4-